Department of Psychiatry and Psychotherapy, LWL-Hospital Bochum, Ruhr University, Alexandrinenstr. 1, 44791, Bochum, Germany.
Eur Arch Psychiatry Clin Neurosci. 2010 Feb;260(1):41-9. doi: 10.1007/s00406-009-0013-5. Epub 2009 Apr 28.
Previous studies pointed out the high prevalence of the metabolic syndrome among patients with bipolar disorder and major depression. A link between depression and a metabolic syndrome remains in dispute despite these studies. This study was conducted to evaluate the occurrence of the metabolic syndrome in depressive inpatients, to analyze the association between the severity of depression and the metabolic syndrome and to screen specific laboratory values in the course of depressive illness. 60 acute depressive patients were recruited for the study and underwent psychometric testing [21-item Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), Clinical Global Impression Scale (CGI) and Global Assessment of Functioning Scale (GAF)] and a metabolic syndrome screening using the modified criteria of the American National Cholesterol Education Program (NCEP) Treatment Panel III (ATP III). Moreover, CRP, cholesterol, HDL-cholesterol, fasting glucose, triglyceride and leptin levels were measured. 42 patients were reexamined in state of (partial) remission. Depression was reassessed using the 21-item HAMD, and laboratory values were analyzed a second time. 25% of the depressive patients fulfilled the criteria of metabolic syndrome (MS+). Only in the MS+ group, a positive correlation between triglyceride blood levels and severity of depression became evident as well in the state of acute depression as in the state of remission. In the group of patients without metabolic syndrome, laboratory values were not associated with severity of depression. An association between metabolic parameters and the course of depression could only be detected in the group of patients with metabolic syndrome. These findings suggest that, in these patients, a beneficial outcome of depressive illness may improve the metabolic situation.
先前的研究指出,双相情感障碍和重度抑郁症患者的代谢综合征患病率较高。尽管有这些研究,但抑郁与代谢综合征之间的联系仍存在争议。本研究旨在评估住院抑郁症患者代谢综合征的发生情况,分析抑郁严重程度与代谢综合征之间的关系,并在抑郁过程中筛选特定的实验室值。研究共招募了 60 名急性抑郁症患者,对他们进行了心理测试[21 项汉密尔顿抑郁量表(HAMD)、贝克抑郁量表(BDI)、临床总体印象量表(CGI)和总体功能评估量表(GAF)]和使用美国国家胆固醇教育计划(NCEP)治疗专家组 III(ATP III)修改标准进行代谢综合征筛查。此外,还测量了 CRP、胆固醇、HDL-胆固醇、空腹血糖、甘油三酯和瘦素水平。42 名患者在(部分)缓解期再次接受检查。使用 21 项 HAMD 重新评估抑郁,再次分析实验室值。25%的抑郁症患者符合代谢综合征(MS+)标准。只有在 MS+组中,在急性抑郁和缓解期,甘油三酯血水平与抑郁严重程度之间呈正相关。在没有代谢综合征的患者组中,实验室值与抑郁严重程度无关。只有在代谢综合征患者组中才能检测到代谢参数与抑郁病程之间的关联。这些发现表明,在这些患者中,抑郁疾病的良好转归可能会改善代谢状况。